Meta‐analysis of drug‐related deaths soon after release from prison

Addiction - Tập 105 Số 9 - Trang 1545-1554 - 2010
Elizabeth L. C. Merrall1, Azar Kariminia2, Ingrid A. Binswanger3,4, Michael Hobbs5, Michael Farrell6, John Marsden6, Sharon Hutchinson7,8, Sheila M. Bird7,1
1MRC Biostatistics Unit, Cambridge, UK
2National Centre in HIV Epidemiology and Clinical Research, Sydney, NSW, Australia,
3Denver Health Medical Center, Denver, CO, USA
4Division of General Internal Medicine, University of Colorado at Denver School of Medicine, Denver, CO, USA,
5School of Population Health, The University of Western Australia, Crawley, WA, Australia
6National Addiction Centre, Division of Psychological Medicine and Psychiatry, Institute of Psychiatry, King's College London, London, UK,
7Department of Statistics and Modelling Science, Strathclyde University, Glasgow, UK and
8Health Protection Scotland, Glasgow, UK

Tóm tắt

ABSTRACTAims  The transition from prison back into the community is particularly hazardous for drug‐using offenders whose tolerance for heroin has been reduced by imprisonment. Studies have indicated an increased risk of drug‐related death soon after release from prison, particularly in the first 2 weeks. For precise, up‐to‐date understanding of these risks, a meta‐analysis was conducted on the risk of drug‐related death in weeks 1 + 2 and 3 + 4 compared with later 2‐week periods in the first 12 weeks after release from prison.Methods  English‐language studies were identified that followed up adult prisoners for mortality from time of index release for at least 12 weeks. Six studies from six prison systems met the inclusion criteria and relevant data were extracted independently.Results  These studies contributed a total of 69 093 person‐years and 1033 deaths in the first 12 weeks after release, of which 612 were drug‐related. A three‐ to eightfold increased risk of drug‐related death was found when comparing weeks 1 + 2 with weeks 3–12, with notable heterogeneity between countries: United Kingdom, 7.5 (95% CI: 5.7–9.9); Australia, 4.0 (95% CI: 3.4–4.8); Washington State, USA, 8.4 (95% CI: 5.0–14.2) and New Mexico State, USA, 3.1 (95% CI: 1.3–7.1). Comparing weeks 3 + 4 with weeks 5–12, the pooled relative risk was: 1.7 (95% CI: 1.3–2.2).Conclusions  These findings confirm that there is an increased risk of drug‐related death during the first 2 weeks after release from prison and that the risk remains elevated up to at least the fourth week.

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Addiction

Tập 105 Số 9

1545-1554

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